Bay Area XERF — Dr. Lisa Hwang

XERF

RadioFrequency Skin Tightening

Skin changes with age are normal and universal. Over time, collagen weakens, skin loses its snap, and support softens along the jawline, under the chin, around the eyes, and through the neck. Makeup, skincare, and weight loss can help how skin looks on the surface, but they can’t rebuild collagen structure once it starts to thin and loosen. That’s where XERF (pronounced "Zerf") comes in.

XERF is a non-invasive radiofrequency treatment that gently heats the deeper layer of the skin to contract existing collagen and stimulate new collagen and elastin. The goal is not to change the way you look — it’s to restore support where it’s starting to fade, so you look more rested, smoother, and subtly lifted without injections, incisions, or downtime. Most patients describe treatment as comfortably warm, and return to normal activity the same day.

Even patients who take excellent care of their skin notice early laxity in the brow/eyelid area, along the jawline and lower face, and in the neck. This is not “bad skincare”; it’s normal tissue aging. XERF is designed for that stage — when you are starting to see softening but are not interested in surgery. Dr. Lisa Hwang will evaluate your brow, midface, jawline, chin, and neck, and design a personalized XERF plan to target the areas that matter most to you. Her goal is to help you maintain definition and confidence with results that develop gradually and look like you.

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Dr. Lisa Hwang

Introducing XERF

I am so excited to offer XERF structural skin tightening, a treatment with NO pain, NO needles, and NO downtime! It is truly innovative and in a category of its own — unlike other skin tightening devices, XERF has no needles, and most importantly, no pain! XERF was just FDA-approved in the US in August 2025, and we are proud to be one of the first plastic surgeons to offer it!

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Problem areas

Brow.

With age, the brow can settle lower and the upper eyelid can start to look heavy. XERF delivers controlled radio frequency energy to the support layer around the brow to stimulate collagen and improve skin firmness. The goal is a subtle, rested look around the upper lid and brow without injectables or surgery.

Midface Support.

Loss of support in the midface can deepen nasolabial folds and make the center of the face look tired. XERF can be used over the cheek to improve skin quality and tension in that area. While it is not a filler and will not replace lost volume, healthier, tighter skin there can soften the appearance of fold depth and make the midface look more lifted.

Cheeks.

As collagen weakens, the tissue in the lower face drifts forward and down, creating early jowls and softening the angle of the jaw. XERF treats along the jawline and lower cheek to contract existing collagen and signal new collagen and elastin production. This can smooth the transition at the corners of the mouth down toward the chin and give the jawline a cleaner, more defined contour.

Procedure.

Before your visit, please arrive with clean skin and avoid makeup, heavy lotions, self-tanner, and strong active ingredients (like retinoids or acids) for 24–48 hours. If we are treating around the mouth and you are prone to cold sores, ask about a preventive prescription so we can safely proceed.

At your appointment, Dr. Lisa Hwang will review your goals, mark treatment zones, and take baseline photos. The skin is then cleansed and a conductive gel may be applied. The XERF handpiece glides over the skin and delivers controlled radiofrequency heat to the deeper layers. You’ll feel comfortable warmth with occasional “toasty” moments while Dr. Lisa Hwang adjusts the energy and depth for even, safe heating. When treatment is complete, the gel is removed and soothing skincare and SPF are applied.

Most patients describe the sensation as mild to moderately warm and tolerable without numbing. It is common to see temporary pinkness for up to an hour (sometimes a bit longer), then the skin returns to normal.

After treatment, keep the area simple and protected for the first 24–48 hours: gentle cleanser, moisturizer, and SPF 30+. Please avoid hot yoga, saunas, intense workouts, and strong actives until any warmth or pinkness has fully resolved. Makeup is generally fine the same day once the skin settles.

recovery.

Recovery from XERF is typically limited to mild, temporary changes in the skin. The skin may feel subtly “tight” over the first several days — this is normal. Most patients are comfortable using gentle moisturizer and sunscreen only for the first day or two.

RESULTS OVER TIME.

You will see an immediate change after the procedure but results will also develop more over time. XERF works by contracting existing collagen and stimulating new collagen and elastin. Many patients notice a slight “snug,” smoother texture, or glow within the first few weeks. The most visible tightening and lift develop gradually over two to six months as collagen matures.

The jawline, lower face, under-chin area, and neck are common areas where patients see crisper definition. Because skin continues to age naturally, results will soften over time. Most treatment plans include two sessions spaced about four to eight weeks apart to build collagen in a controlled way, and then maintenance every six to twelve months (or longer) depending on your goals and rate of aging.

RISKS & CONSIDERATIONS.

XERF is a non-invasive radiofrequency treatment and is generally well tolerated. Possible risks include redness, swelling, tenderness, temporary welts or heat bumps, and (rarely) blisters or superficial burns. There is a very low risk of pigment change compared to many light-and laser-based devices, but this risk still exists and is higher in recently tanned skin.

Patients with active skin infection in the treatment area, certain implanted electronic devices (such as pacemakers/defibrillators), or who are pregnant may not be candidates and should discuss this with Dr. Lisa Hwang prior to treatment. As with any collagen-stimulating procedure, individual results vary. You can expect improvement, but not the same degree of change as surgery.

FAQs

Who is XERF RF Skin Restructuring for?

XERF is a good match if you want noticeably firmer skin without injections or surgery. It suits mild to moderate laxity on the face, neck, or select body areas and early signs of aging like soft jawline definition or fine lines. If your schedule is busy, the no-downtime profile makes it easy to return to normal activity the same day. We can customize settings for most skin types after an in-person evaluation.

Why might two sessions be recommended for me?

Collagen remodeling is cumulative: two thoughtfully spaced sessions typically outperform one higher-energy visit. Splitting the energy lets us reach the same (or better) endpoint with more comfort and less reactivity, especially for sensitive or pigment-prone skin. We usually recommend spacing sessions 4-8 weeks apart; improvements continue to build for several months. Some patients are happy after one, but many see the “wow” land after the second.

What results can I expect?

Expect gradual tightening and lift, softer fine lines, and smoother texture as new collagen and elastin form. The jawline and cheeks often look a touch more defined, and the skin takes on a healthier, more even look. Early changes can show within a few weeks; the most meaningful improvement typically appears over 2-6 months as collagen matures.

How long will my results last?

Radiofrequency skin tightening like XERF stimulates your own collagen, which can be long-lasting, but your skin keeps aging (and collagen keeps breaking down), so the effect will gradually soften over time at the rate of your natural aging. You can wind back the hands of the clock, but the clock will still tick forward!

What credentials does Dr. Lisa Hwang hold?

Dr. Lisa Hwang, MD, FACS is a board-certified plastic surgeon specializing in aesthetic surgery. She is certified by the American Board of Plastic Surgery (ABPS) and has completed extensive training, including full residencies in both general surgery and plastic surgery, followed by an aesthetic surgery fellowship endorsed by the American Society for Aesthetic Plastic Surgery (ASAPS).

Dr. Hwang is an active member of several esteemed professional societies, including ASAPS, the American Society of Plastic Surgeons (ASPS), the California Society of Plastic Surgeons (CSPS, and the American College of Surgeons (ACS). Her practice reflects a commitment to surgical precision, artistic vision, and compassionate, personalized care.

What does XERF RF Skin Tightening cost?

Costs can vary based on your individual goals. Reach out to us with the details of what you’re considering, and we’ll provide a ballpark estimate.